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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A stroke with a somewhat unusual neurologic formula was correlated with a small linear high-intensity T2 focus in the lateral tegmentum of the lower third of the pons. The clinical features included dysarthria, staggering gait, incoordination of handwriting, right facial weakness, nystagmus, ocular overshoot, right appendicular ataxia, and left-sided dissociated sensory loss for pain and temperature. Lacunar lesions of the tegmentum in the region of the pontomedullary junction, while not uncommon, have not been studied pathologically and have not been reported in the magnetic resonance imaging literature, to my knowledge.
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PMID:Lacunar infarct of the tegmentum of the lower lateral pons. 271 52

A previously healthy 6-year-old boy, suddenly developed a complete right hemiparesis and dysarthria while playing at school without any history of trauma. All laboratory examinations were normal except for CT brain scan that revealed a small ischemic infarct in the left middle cerebral artery territory. Four vessel cerebral angiography demonstrated a left internal carotid artery dissective obstruction while filling of the right or left vertebral artery resulted in the simultaneous retrograde appearance of the respective middle cerebral artery possibly via the posterior communicating artery. In contrast to the literature data, the patient showed a significant recovery with conservative treatment. This uncommon stroke type in children and the possible protective role of the posterior communicating artery's collateral are further discussed.
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PMID:Ischemic infarct in childhood secondary to internal carotid artery dissection. Report of a case. 279 64

Symptomatic common carotid artery occlusion (CCAO) is rare. We studied 17 patients with ischemic cerebrovascular symptoms and unilateral CCAO on angiography to help clarify clinical and radiologic features. Mean age was 62 years; 65% were women. Predominant symptoms and signs included visual-ipsilateral monocular or retrochiasmal symptoms (88%), motor weakness (88%), sensory disturbance (59%), dizziness/lightheadedness (53%), and syncope (24%). Dysarthria, headache, or involuntary limb shaking occurred less frequently. Positionally related symptoms occurred in approximately two-thirds of the patients. TIAs were often multiple and preceded a stroke or occurred without subsequent stroke in 82%. Hemispheric TIAs contralateral to the CCAO occurred in 41%. Ten patients (59%) suffered stroke, seven (70%) of which were ipsilateral to the CCAO. Vascular risk factors included cigarette use (76%), hypertension (71%), diabetes mellitus (41%), and hyperlipidemia (41%); 82% had two or more risk factors. Known cardiac disease was present in 59%. CCAO was present at the origin of the vessel in most patients. Most had atherosclerotic narrowing of multiple extracranial large vessels. During follow-up, none of the patients had a spontaneous second infarct; five had TIAs, including two with amaurosis fugax, all in the CCAO territory. More restricted external carotid collaterals may, in part, explain the higher frequency of ipsilateral stroke and contralateral TIAs than reported for internal carotid occlusion.
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PMID:Common carotid artery occlusion. 279 68

A 42-year-old man presented with right temporal headache, dysarthria, and dysphagia. On examination, he had a right hypoglossal nerve palsy. The diagnosis of right internal carotid artery dissection was suggested by magnetic resonance imaging and confirmed by carotid angiography. A dynamic computed tomogram demonstrated enlargement of the carotid artery. In carotid dissection, the hypoglossal nerve may be compromised by local factors as it passes close to the carotid artery in the neck.
Stroke 1988 Sep
PMID:Spontaneous internal carotid artery dissection presenting as hypoglossal nerve palsy. 304 72

Lacunar strokes result from occlusion of penetrating arteries in the deeper, subcortical parts of the cerebrum and brain stem. Approximately 19 percent of all strokes are of the lacunar variety with lacunar strokes representing the most common cerebrovascular complication of chronic hypertension. Four major clinical syndromes are pure motor hemiparesis, pure sensory stroke, ataxic hemiparesis, and the dysarthria-clumsy hand syndrome. The advent of computed tomography (CT) has allowed the antemortem study of lacunar disease and has shed new light on the pathogenesis and clinical course of lacunar strokes. Recently, it has been demonstrated that lacunar strokes may be embolic or hemorrhagic in causation, are not invariably associated with hypertension, and may be larger and associated with hypertension, and may be larger and associated with neurological manifestations that do not conform to the classic patterns. In most instances, however, recognition of the characteristic clinical presentation and confirmation of the diagnosis with noninvasive studies spare many patients unnecessary risks associated with anticoagulation, arteriography, or vascular surgery.
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PMID:Lacunar strokes: current concepts. 304 29

A review of recent research conducted at the Rusk Institute of Rehabilitation Medicine in New York City concerning speech and language deficits in closed head injured patients (CHI). One hundred and twenty-five consecutive admissions of 125 closed head injured post coma patients were administered standardized aphasia tests to determine the presence and nature of verbal deficits. Mean time since injury for the group was 45 weeks. All patients, without exception, evidenced linguistic impairment. The population fell into three relatively equally sized groups: classic aphasia, dysarthria accompanied by linguistic deficits, and "subclinical" aphasic deficits. The study results suggest that linguistic functions are particularly vulnerable in severe head injury. A second study compared aphasia secondary to CVA and CHI. When age and time since onset were controlled, aphasic CHI and CVA patients are more similar than different in linguistic task performance and overall functional communication effectiveness. The results suggest that the therapeutic approaches traditionally implemented with CVA aphasic patients are appropriate for the management of CHI aphasic patients as well.
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PMID:Language and speech defects. 316 12

A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.
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PMID:Selective impairment of phonation: a case study. 320 76

We examined case of intracerebral hemorrhage presenting as lacunar syndrome. Of 115 cases, 10 presented with a lacunar syndrome: 3 presented with pure motor hemiparesis, 1, pure sensory stroke, 1, ataxic hemiparesis, 5, sensorimotor stroke, and, none, dysarthria--clumsy hand syndrome. The sites of hemorrhage were capsular in 1, pontine in 1, thalamic in 4, and putaminal in 4. In these 10 patients, 9 were hypertensive, and the signs characteristics of parenchymal hemorrhage, e.g., headache, nausea, vomiting, and stiffness of neck, were absent or rare.
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PMID:Lacunar syndrome and intracerebral hemorrhage: clinico-computed tomographic correlations. 320 39

A dichotic-listening procedure was used to investigate the role of the right hemisphere in recovery from aphasia following left-hemisphere stroke. Thirty-one stroke patients were divided into three groups: (a) patients who were recovering from aphasia (Aphasic group, n = 11), (b) patients who had experienced mild strokes with only transient dysarthria (Dysarthric group, n = 10), and (c) patients who had sustained right-hemisphere stroke with no language disturbance (Nonaphasic group, n = 10). In addition, a group of normal, healthy volunteers served as a control group (n = 11). Results show that, like the Control subjects, the Dysarthrics and Nonaphasics showed a strong right-ear advantage (REA) for dichotically presented consonant-vowel (CV) syllables. This is usually thought to be an indication of left-hemisphere dominance (Kimura, 1961). By contrast, the Aphasic group showed left-ear advantage (LEA) suggesting a shift in cerebral dominance for language. The possibility that the results were due to sensory degradation of the auditory messages (lesion effect) was explored. This idea was rejected in favor of an explanation based on increased right-hemisphere mediation of language following left-hemisphere aphasiogenic lesions.
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PMID:Dichotic-listening evidence of right-hemisphere involvement in recovery from aphasia following stroke. 340 1

Migraine headaches that occur in the 15- to 30-year-old age group are well documented. In patients in the stroke age bracket, however, who present with a history of neurologic deficit, transient ischemic attacks can be confused with migraine accompaniments. The typical patient is 50 years old, is without a past history of migraines, and complains of scintillating visual disturbances (20 percent), marching paresthesis (22 percent), or a myriad of neurologic deficits. In one series of 70 neurology patients aged over 55 years, 16 percent reported that they experience the new onset of scintillations. Once fully evaluated, the cause of unexplained marching paresthesias, dysphagia, or hemiplegia, once reserved for thrombotic or embolic phenomena, may be attributed to migraine accompaniments. In the face of a normal evaluation, neurologic deficit in the stroke age bracket may be attributed to migraine accompaniments. A case of a 47-year-old woman with sudden onset of left-sided paresthesia, dysarthria, and confusion is presented. The discussion includes a description of migraine pathophysiology and a review of concepts regarding accompaniments.
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PMID:Late-life migraine accompaniments: a case presentation and literature review. 358 61


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